10/21, Nimo, amps 505

[Nimo's mom]

Hi everyone,
Unfortunately Nimo is back on insulin. He was dx back in February but we were able to get it controlled with diet until he gained too much weight. I kept reducing his feedings but he was starving and not losing weight so the vet put him on m/d. He has lost 2 pounds but his numbers are now very high. I'm a bad kitty mom because I didn't check his numbers for over a month
He's on weruva paw lickn' chicken now. Hopefully he won't gain weight and his numbers will start to come down soon.
The hard part is just being patient.
Oh, and I'm using 2 meters right now, the alpha trak 2 and the relion confirm and just use different colors on my ss.
Hope everyone is doing well today!!

 

[Rachel & Chyna (GA)]

Hi Nimo, and Nimo's mom Just wanted to say hello and welcome, I don't think I've said hi before. I hope that the insulin does well for Nino and the fuds change helps the weight :smile: My kitty LOVES the paw lickin chicken, unfortunately she is now off all chicken as she is allergic :cry: I know, it's so hard to be patient! Hope you have a good day!

 

[Dyana]

I would slow down on the increases. The depot takes 5 to 7 days to form. You don't want to pass by a good dose.
We recommend 5 to 7 days to start and then letting letting each dose adjustment have time to settle.

I hope he comes down into some nice blues for you tonight.

 

[Marje and Gracie]

Sorry you and Nimo have to be back.

Because he is coming back from remission and his numbers were so high AND we've found that cats coming back from remission typically exceed the highest dose they were on before, I think his starting dose could have been higher but you took him up to his highest previous dose pretty quickly. I'd agree with Dyana that you need to slow it down now. From Tilly's website and the TR protocol:

However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU.

So I would definitely give him six cycles at a dose before increasing, if nadirs are high. And the above quote applies to nadirs using a human glucometer. If he's coming down to yellow nadirs now (with the Relion), I'd only increase him by .25u every six cycles as long as he is high and flat. You'll want to slow it down if he starts getting some blue numbers.

My other suggestion to you right now is pick one meter....either the AT or the Relion and stick with it. Please annotate on your SS and your signature block which meter you are using because there is a difference in the suggestions we make based on the meter you are using.

 

[julie & punkin (ga)]

hi nimo's mom! welcome back! let's hope nimo has a short visit here again this time.

it's important to note that just because you see high numbers, it doesn't necessarily mean he needs more insulin. as you get tests and we can see patterns in his spreadsheet, that will tell what his dose needs to do. sometimes high numbers tell us that the dose is too high. sometimes numbers are high because the cat is "bouncing" from having hit a low number.

i agree completely with dyana. Lantus takes time to work and every dose change needs time to settle.

here's the relevant part of the protocol for you, copied from the yellow starred sticky at the top of this forum page:

REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.


Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

it's going to be very important for you to get the regular tests in as it mentions above.

lantus takes time to work so it's very important that you take time before you adjust doses, unless you get a less than 50. other than that, you want to hold the dose without adjusting for several days. Lantus has to build up a deposit in the body and then you'll see what the dose "does" for him.

if you could post here daily we can help you learn to read the numbers so you know what to do with the dose.

 

[Sienne and Gabby (GA)]

Hi, Collette. Sorry that Nimo decided to come back and rent a condo. You've gotten some great input from Dyana, Marje, and Julie. You might want to review the TR protocol just so it's fresh in your mind. (It's amazing how quickly what was routine leaves our memory!) I hope this is a short stay. The M/D that your vet prescribed is way high in carbs -- not the best food for a diabetic kitty.

Please let us know how we can help.